News & Analysis as of

Medicaid Health Insurance Insurance Industry

Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with... more +
Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with children.  less -
BakerHostetler

Alive and (Anti)Kicking: EKRA Prosecutions on the Rise in California with Multiple Recent Indictments

BakerHostetler on

In the past few months, federal prosecutors in California have brought multiple indictments under the Eliminating Kickbacks in Recovery Act (EKRA) charging the owners of substance abuse treatment facilities and their...more

McDermott Will & Schulte

Key updates on the US health benefits and reimbursement landscape

The world of health benefits is constantly evolving. Recent policy shifts and legislative developments are expected to impact the economic landscape and have significant implications for employer plan sponsors, insurers,...more

McCarter & English, LLP

One Big Beautiful Bill Act Tax Law Updates – Healthcare Sector

On July 4, 2025, President Trump signed into law the legislation commonly referred to as the “One Big Beautiful Bill Act” (OBBBA), which includes significant changes to Medicaid, Medicare, and Affordable Care Act (ACA)...more

Davis Wright Tremaine LLP

Navigating Aetna's Expanded Claim Edits: What Providers Need To Know and Do Before September 1, 2025

Aetna recently announced that effective September 1, 2025, its Claim and Code Review Program (CCRP) will expand to include additional claim coding edits for all commercial, Medicare, and Student Health claims. While the...more

J.S. Held

All Is Not What It Seems, Or When Is A Dollar A Dime?

J.S. Held on

Welcome to the strange and mysterious world of medical billing. If ever there was an industry in which the charges and the payments have no correlation, the medical industry is it. Medical billing can indeed be quite...more

Bass, Berry & Sims PLC

Healthcare Regulatory & Compliance Summit 2025 Recap

Health Policy Fireside Chat: What to Expect from the New Administration - Bill Mathias, Member at Bass, Berry & Sims, engaged in a fireside chat with Colin Roskey, Principal at FHP Strategies, former Deputy Assistant...more

McDermott Will & Schulte

Trending in Telehealth March 2025

Trending in Telehealth highlights monthly state legislative and regulatory developments that impact the healthcare providers, telehealth and digital health companies, pharmacists, and technology companies that deliver and...more

Bond Schoeneck & King PLLC

New “Network Adequacy” Rules May Present Opportunities to Behavioral Health Agencies

New York State recently adopted “network adequacy” regulations that will require health care plans in the state to improve access to behavioral health services, including mental health and substance use treatment services....more

ArentFox Schiff

Massachusetts Enacts Drug Pricing Legislation: Introducing PBM Licensure, Mandatory Cost Reporting, and Consumer Cost-Sharing...

ArentFox Schiff on

On January 8, Massachusetts Governor Maura Healy signed into law “An Act Relative To Pharmaceutical Access, Costs And Transparency.” The Act will have a profound impact on all parties involved in setting and applying drug...more

Foley & Lardner LLP

Medicare Payment Model Trends and Economic Drivers – Awaiting Direction from Trump Administration

Foley & Lardner LLP on

The Medicare program continues to face long term financial pressures associated with inflationary effects on health care costs and the growing wave of aging baby boomers. The Medicare Trust Fund, which is often viewed as a...more

McDermott Will & Schulte

New York Executive Budget Proposes Amendments to MCO Provider Tax

The New York State Executive Budget for Fiscal Year (FY) 2026 proposes significant updates to the managed care organization (MCO) provider tax, aiming to enhance Medicaid funding through innovative financial strategies. The...more

Nelson Mullins Riley & Scarborough LLP

Gold Dome Report - Legislative Day 8 - January 2025

Visitors to the Georgia State Capitol were delighted by the rhythm and artistry of a lion dance in the South Wing on Wednesday as the Asian American Pacific Islander Legislative Caucus hosted its second annual Lunar New Year...more

McAfee & Taft

Gavel to Gavel: Justice Department takes aim at private health plan fraud

McAfee & Taft on

Historically, the U.S. Department of Justice has directed its efforts on combatting healthcare fraud by focusing on persons and companies who defraud or attempt to defraud federally funded healthcare programs, such as...more

McDermott Will & Schulte

Trending in Telehealth: September 17 – 30, 2024

McDermott Will & Schulte on

Trending in Telehealth highlights state legislative and regulatory developments that impact the healthcare providers, telehealth and digital health companies, pharmacists, and technology companies that deliver and facilitate...more

Venable LLP

NAIC Working Group Approves Revisions to Regulate Health Insurance Lead Generators

Venable LLP on

This August, a working group sponsored by the National Association of Insurance Commissioners (the "NAIC") unanimously approved revisions to the NAIC's Unfair Trade Practices Act Model #880 (the "Model Law") to restrain...more

Patrick Malone & Associates P.C. | DC Injury...

Better Health Care Newsletter - August 2023

A Social Media prescription from America’s top doctor - Imagine sending your teen-aged kid or grandkid out every day to a full-time job in the tech industry. The hours are flexible, and they say they like it...sort of....more

McDermott Will & Schulte

Top Takeaways | Employer Market Perspective

In this session, McDermott Will & Emery Partner Patrick Healy moderated a panel that examined the expansion of value-based care in the employer market. We summarize the panel’s insights on how stakeholders can successfully...more

Goodwin

Federal District Court Ruling May Jeopardize Insurance Coverage of More Than 50 Recommended Procedures, Screenings, and Treatments

Goodwin on

Under the Affordable Care Act, group health plans and health insurance issuers are required to provide health insurance coverage based on recommendations made by healthcare coverage professionals. The covered categories...more

Mitchell, Williams, Selig, Gates & Woodyard,...

National Association of Insurance Commissioners (NAIC) 2022 Summer Meeting Summary

The Mitchell Williams Insurance Regulatory team of lawyers recently attended the National Association of Insurance Commissioners (NAIC) 2022 Summer National Meeting which was held in Portland, Oregon on August 9-13th. We have...more

Lasher Holzapfel Sperry & Ebberson PLLC

Two Major Changes Address Living-With-COVID Concerns

A national vaccination mandate directed at employers with more than 100 employees became effective 1/10/2022. Although the U.S. Supreme Court has expedited oral arguments regarding judicial stays facing the mandate, the...more

Mitchell, Williams, Selig, Gates & Woodyard,...

2021 Arkansas Insurance Legislation Summary: Health Insurance

The 93rd Arkansas General Assembly convened on January 11, 2021 and entered into an extended recess on April 27, 2021. The resolution authorizing the extended recess provides for the legislature to reconvene for the following...more

McDermott Will & Schulte

New Laws Expand Telehealth in California

California Governor Gavin Newsom recently signed into law two bills that expand the delivery of telehealth services in the state. In particular, the legislation: • Permits providers to prescribe medications without a...more

Patrick Malone & Associates P.C. | DC Injury...

Will Rx drug costs fall if U.S. puts squeeze on middlemen and curbs rebates?

The Trump Administration has put out its latest prescription to try to slash out-of-control prescription drug prices: Officials want to call medication “rebates” what they say they’ve really become — “kickbacks” — and crack...more

Epstein Becker & Green

26 Days: Congress and Health Care as FY 2017 Comes to a Close

Congress returns from August recess today, facing a daunting workload to complete before the end of the current fiscal year (FY) on September 30. Big picture issues include raising the national debt ceiling and passing a...more

Downs Rachlin Martin PLLC

News From the Vermont Statehouse - An Analysis from DRM’s Government & Public Affairs Team - April 2017

Trial Bar Proposes Anti-Ride-Sharing Amendments to Insurance Bill - The Senate Judiciary Committee considered amendments this week proposed by the Vermont Trial Lawyers Association that would likely force Uber out of...more

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